Kornimate/medical-research-clean huggingface dataset:
endoscopic biliary rfa of malignant bile duct obstruction

Conditions: Cholangiocarcinoma; Bile Duct Obstruction

Summary: endoscopic radiofrequency ablation (rfa) is a new palliation therapy for malignant bile duct obstruction. it delivers a high amount of thermal energy to target tissue and may prolong the duration of stent patency. rfa has showed promising results for malignant bile duct obstruction and increasing the duration of stent patency. the aim of our study was to evaluate the feasibility and safety of endoscopic rfa for the treatment of bile duct obstructions, and to compare the efficacy of endoscopic biliary rfa with the addition of self-expanding metal stents (sems) to sems alone in a randomized controlled trial.

malignant bile duct obstructions are caused by many diseases arising from primary or metastatic disease in intrahepatic, extrahepatic or hilar locations. to relieve obstructive decompression and jaundice as a result of the obstruction, endoscopic stent placement is usually required. compared with surgical intervention, stent insertion offers shorter hospitalization, lower overall cost and lower morbidity. previous studies have shown the superiority of semss over plastic stents for maintaining biliary drainage. however, sems can occlude due to epithelial hyperplasia, tumor in-/overgrowth, biofilm deposition and sludge formation. studies have showed that the median sems patency is 120 days. once bile duct obstruction reoccurs, it may lead to significant morbidity and mortality. thus, long-term patency of the sems remains an unresolved issue. recently, endoscopic biliary radiofrequency ablation (rfa) have been used in patients suffering from inoperable malignant bile duct obstruction, and increasing the duration of stent patency. it delivers a high amount of thermal energy to target tissue with curative or palliative intent. the purpose of this study is to record information and evaluate the impact of radiofrequency ablation in improving the management of cholangiocarcinoma or malignant bile duct obstruction, and to compare the effects of sems plus rfa to sems alone.

Eligibility criteria:
inclusion criteria: 1. histologically (preferred) or radiologically confirmed distal malignant bile duct tumors 2. inoperability by staging, comorbidities or patient wishes exclusion criteria: 1. history of bleeding disorder or use of anticoagulation 2. prior cardiac pacemaker placement 3. presence of serious dysfunction of heart, lung or kidney. 4. presence of other malignancy 5. pregnancy 6. prior sems placement 7. prior billroth ii or roux-en y reconstruction
levels of pigment epithelium-derived factor in patients with psoriasis.

Conditions: Psoriasis

Summary: psoriasis is an immune-mediated chronic inflammatory skin disease associated with increase interaction of inflammatory mediators like adipokines. pigment epithelium-derived factor (pedf) is one of the most abundant adipokines and have anti-angiogenesis effect. there is a study showed that pedf level is up-regulated in the sera of psoriasis patients.


Eligibility criteria:
inclusion criteria: patients with psoriasis and group of age and sex-matched healthy volunteers will be included as a control group. exclusion criteria: * pregnancy. * patients with other inflammatory skin disorders. * patients on antioxidants or anti-inflammatory drugs. * patients on topical or systemic treatment for psoriasis in the last 4 weeks prior to enrollment in the study. * patients on systemic retinoids (acitretin). * obesity: body mass index (bmi ) \> 30. * malignancies e.g squamous cell carcinoma. * viral warts. * diabetes. * hypertension.
the israeli study for islet autoantibodies screening in families of type-1 diabetes patients

Conditions: Type 1 Diabetes

Summary: we aim at establishing a research program that will offer screening for the presence of islet autoantibodies (ia) in relatives of people with type 1 diabetes (t1d). relatives of people with diabetes, children, and adults from our clinic and all over israel will be offered to participate in the study. the presence of ia will be evaluated using the detection by agglutination-pcr (adap) technology developed by enable biosciences, which is 1,000-10,000 times more analytically sensitive than currently used methods.. when positive in the screening, multiple antibodies will be confirmed by a second sample analyzed by the adap technology and by a radio binding assay (rba). people positive for one or more antibodies (stage 1 or 2 t1d) will be referred to attend an educational program at our center. this program will include diabetes education emphasizing dka prevention as well as stress assessment for the families involved and stress alleviating interventions. after the educational visit, people at risk of developing diabetes will be referred to further follow-up and evaluation under routine medical care at our center.


Eligibility criteria:
inclusion criteria: * first degree family member (sibling or parent) of a known t1d patient * age 2-45 years * signing an informed consent exclusion criteria: * known diabetes of any kind (type 2, mody) * have a previous history of being treated with insulin or oral diabetes medications. * currently be using systemic immunosuppressive agents (topical and inhaled agents are acceptable)

Keywords: stage 1 diabetes stage 2 diabetes
whole course multi-model prehabilitation to improve clinical outcome in patients undergoing neoadjuvant treatment prior to gastrectomy

Conditions: Gastric Cancer; Prehabilitation

Summary: the intention of research is to establish a multimodal prehabilitation protocol in patients who undergo neoadjuvant chemotherapy prior to gastrectomy, explore the feasibility and effectiveness of the measures and evaluate the effect of program on short-term clinical outcome, fitness and long-term prognosis.


Eligibility criteria:
inclusion criteria: 1. aged ≥18 years; 2. eastern cooperative oncology group (ecog) performance status score ≤2； 3. endoscopic biopsies were pathologically confirmed as gastric adenocarcinoma； 4. the feasibility of neoadjuvant therapy was suggested by mdt, and the feasibility of radical gastrectomy was re-evaluated after neoadjuvant therapy; 5. blood routine, liver function, kidney function, heart function and lung function were normal before neoadjuvant therapy, and there was no contraindication of chemotherapy and surgery; 6. the pregnancy test was negative within 1 month, and she was not pregnant or breastfeeding; 7. informed consent and ability to comply with research protocols. exclusion criteria: 1. metastasis; 2. end-stage cardiac insufficiency (lvef\<30% or nyha class iv), liver cirrhosis (child-pugh classification c), end-stage renal failure (receives chronic dialysis), or asa grade iv; 3. cerebral hemorrhage, cerebral infarction, tia or central nervous system disease or mental illness within 6 months, could not cooperate with the completion of neoadjuvant therapy and pre-rehabilitation exercise; 4. patients have severe infections (such as mods, etc.) or have allergic reactions to chemotherapy drugs and metabolic disorders; 5. concurrent tumors or other diseases requiring simultaneous surgery (except laparoscopic gallbladder surgery); 6. emergency surgery is required due to tumor complications (e.g., bleeding, perforation, obstruction); 7. patients participating in other clinical trials.

Keywords: multimodal prehabilitation neoadjuvant chemotherapy
interventional clinical trial for ccsvi in multiple sclerosis patients

Conditions: Multiple Sclerosis

Summary: to investigate the safety and tolerability of balloon venoplasty compared to sham in multiple sclerosis patients with chronic cerebrospinal venous insufficiency (ccsvi) as measured by adverse events occurring within 48 weeks of the procedure.

overview of study objectives are: * to determine the safety and tolerability of venoplasty of ccsvi in multiple sclerosis (ms). * to determine the short term and long term impact on validated patient measures and by physician and radiologic reported ms outcomes. * to determine the short term and long term recurrence rate of ccsvi for veins that have been treated with venoplasty

Eligibility criteria:
inclusion criteria: * diagnosis of relapsing remitting multiple sclerosis (rrms) or secondary progressive ms according to the mcdonald criteria 2010 * age 18 to 65 years inclusive * neurostatus (edss) score at screening from 0 to 6.5 * fulfill ultrasound criteria for ccsvi exclusion criteria: * previous venoplasty and/or stenting of extra cranial venous system

Keywords: multiple sclerosis ms ccsvi zamboni catheter venography balloon angioplasty
maintenance intermittent therapy for symptomatic gerd patients

Conditions: Gastroesophageal Reflux Disease

Summary: the purpose of this study to determine the efficacy of 20 mg of rabeprazole given as a maintenance intermittent therapy following acute treatment for symptomatic gastroesophageal reflux disease (s-gerd).


Eligibility criteria:
key inclusion criteria: 1. male or female patients, 18 to 65 years of age. 2. if female, not of childbearing potential by reason of surgery, radiation or menopause, or of childbearing potential, but using an approved method of contraception since the last menstrual period, for example, intrauterine device (iud), implant, double barrier method, or oral contraceptives for at least one cycle. females of childbearing potential must have a negative urine pregnancy test before medication is dispensed. 3. patients must report a minimum three-month history of gerd symptoms. gerd symptoms are defined as heartburn with or without regurgitation or other associated gerd symptoms. 4. patients must have at least 4 days with heartburn per week in each of the 2 weeks prior to screening. 5. patients must have no esophagitis, with no proton pump inhibitors (ppis, prescription or otc), h2 blockers (prescription or otc) or prokinetics within 14 days, prior to the endoscopy. key exclusion criteria: 1. evidence of significant hepatic, renal, respiratory, endocrine, hematologic, neurologic, psychiatric or cardiovascular system abnormalities, unless the sponsor and investigator agree that the nature and severity of any abnormality is unlikely to interfere with the conduct of the study, the interpretation of study results, or the health of the patient during the study. 2. females must not be pregnant, lactating or have a positive urine eta human chorionic gonadotropin (b-hcg) laboratory result. 3. patients with a history of allergy or sensitivity to proton pump inhibitors or to their inactive ingredients. 4. patients with known gastric ulcer, duodenal ulcer, infectious or inflammatory conditions of the small or large intestine, malabsorption syndromes, obstruction, a history of gastrointestinal malignancy, or prior gastric or intestinal surgery (including vagotomy). 5. patients who have a history of barrett's esophagus, esophageal stricture, or pyloric stenosis. 6. patients with a history of endoscopically-proven esophagitis any time in the past. 7. patients who have taken proton pump inhibitors (ppis, prescription or otc), h2 blockers (prescription or otc) or prokinetics within 14 days, prior to screening endoscopy, or any of these medications within 7 days prior to the single-blind placebo run-in period.

Keywords: non-erosive symptomatic gerd gerd
decision-making and quality of life surrounding hematologic disease and gene therapy

Conditions: Transfusion Dependent Beta Thalassemia; Sickle Cell Disease

Summary: determine knowledge, attitudes, and beliefs among adult patients, and parents of pediatric patients, with transfusion dependent beta-thalassemia and sickle cell disease toward gene therapy to treat their or their child's illness, and to assess the likely impact of gene therapy on patients' quality of life.

the overarching aim of this research is to determine knowledge, attitudes, and beliefs among adult patients, and parents of pediatric patients, with transfusion dependent beta-thalassemia toward gene therapy to treat their or their child's disease, and to assess the likely impact of gene therapy on patients' quality of life. we will compare and contrast these findings to those obtained from a sample of adult patients and parents of pediatric patients with sickle cell disease. we will also assess perceptions of the pros/cons of gene therapy, including its financial and time costs.

Eligibility criteria:
inclusion criteria: * adult patients (ages 18+) or parents of pediatric patients (\<age 18) eligible to receive treatment for their disease with gene therapy exclusion criteria: * non-english-speaking

Keywords: quality of life
nc-6004(nanoplatin) and gemcitabine to treat pancreatic cancer in asia

Conditions: Locally Advanced and Metastatic Pancreatic Cancer

Summary: the purpose of this study is to determine the recommended dose of nc-6004 according to the dose-limiting toxicity (dlt) in combination with gemcitabine, and to assess the efficacy, safety and tolerability.


Eligibility criteria:
inclusion criteria: * patients with chemo-naive, advanced pancreatic cancer * nonresectable, histologically or cytologically confirmed, locally advanced or metastatic pancreatic cancer exclusion criteria: * pulmonary fibrosis or interstitial pneumonia * marked pleural effusion or ascites above grade 2 * severe drug hypersensitivity * metastasis to the central nervous system and brain

Keywords: pancreatic cancer gemcitabine
pilot rct and interview study on an hiv chatbot in nigeria

Conditions: HIV

Summary: this study will investigate the use of a hiv chatbot that acts as an informational coach. the main question the study aims to answer is: does the chatbot improve hiv knowledge in adults (18-45 years) newly diagnosed with hiv in nigeria - compared to a control group? moreover, the study will also determine potential effects of the chatbot use on patients' resilience, psychological well-being, and viral load. the study will explore patients' use and perceptions of the chatbot, as well as potential gender differences. the control group will receive standard of care only. patients in the chatbot intervention group will interact with the chatbot in addition to receiving standard of care. they will be able to: * use a chatbot via whatsapp * receive information on relevant hiv topics * get automated responses to their hiv-related questions * be reminded of medical appointments and medication schedules


Eligibility criteria:
inclusion criteria: * diagnosed with hiv * art enrollment: at the day of recruitment or in the subsequent 7 days, but no longer than 4 weeks prior to enrolment in the study. * age ≥ 18 and ≤ 45 years * have a personal internet-enabled smartphone with whatsapp installed * carry the phone with them at the time of recruitment * able to understand, read, and write in english (the official language in nigeria) * able to understand the information about the study * provide written informed consent. exclusion criteria: * known pregnancy or ≤3 months postpartum * persons with suicidal ideation and/or severe mental distress

Keywords: chatbot hiv nigeria hiv knowledge gender
acupuncture and nausea/vomiting in pediatric patients

Conditions: Postoperative Vomiting and Nausea

Summary: the purpose of this study is to investigate the effects of intraoperative p6 acupuncture plus standard therapy on postoperative nausea and vomiting in pediatric patients undergoing tonsillectomy with or without adenoidectomy. 200 children will be randomly assigned to either the treatment or the control group. 1. treatment group: standard anti-emetic therapy plus bilateral p6 acupuncture after the induction of anesthesia 2. control group: standard anti-emetic therapy only this study will monitor nausea, retching, and vomiting events both directly after the surgery as well as the next day via a follow-up phone call to the parents of the study participant.


Eligibility criteria:
inclusion criteria: * asa 1 to 3 physical status * undergoing tonsillectomy and/or adenoidectomy * consent obtained from parent/guardian exclusion criteria: * taking preoperative steroids, including inhalers * taking baseline anti-emetics * history of motion sickness * bmi \> 35 (morbid obesity) * severe osa (apnea/hypopnea index \> 10) * have genetic abnormalities
delayed against rapid sequence induction in adults with medical diseases undergoing emergency endotracheal intubation.

Conditions: Intubation in Intensive Care Units

Summary: the goal of this clinical trial is to learn if it is feaseble to conduct a superiority trial comparing two methods for endotracheal intubation in critically ill patients. it will also learn about validity of outcomes regarding endotracheal intubation. the main questions it aims to answer are: * does performing intubation via delayed sequence induction lower the incidence of severe hemodynamic complications compared to rapid sequence induction? * how are hemodynamic complications in the severely ill to be measured in order to minimize bias? participants will: * receive emergency endotracheal intubation via delayed or rapid sequence induction * receive a phone call 90 days after endotracheal intubation * outcome parameters outside of follow up phone calls will be routinely collected during the regular icu-stay, there won't be any additional testing


Eligibility criteria:
inclusion criteria: * adult patients 18 years or older in need of emergency endotracheal intubation in the following 60 minutes. * the planned operateur routinely performs endotracheal intubation in critically ill patients. exclusion criteria: * endotracheal intubation performed during cardiopulmonary resuscitation or during "unstable rosc", defined as norepinephrine or epinephrine dose \> 0,5 µg/kgkg/min after return of spontaneous circulation. * participation in the study is not warranted because of increased risk for the patient or otherwise not justifiable (e.g. active oral bleeding). * known allergy against ketamine, esketamine, midazolam or rocuronium. * known contraindication against ketamine, esketamine midazolam or rocuronium. * known or anticipated difficult airway with indication for awake fiberoptic intubation. * women with known pregnancy or breastfeeding.

Keywords: intubation airway management acute respiratory failure intensive care unit rapid sequence induction delayed sequence induction intubation in intensive care units
ofatumumab versus rituximab in children with steroid and calcineurin inhibitor dependent idiopathic nephrotic syndrome

Conditions: Nephrotic Syndrome

Summary: open-label, two-parallel-arm, controlled randomized clinical trial testing the superiority of ofatumumab over rituximab in maintaining steroid- and calcineurin-inhibitor-free disease remission in sd-ins. eligible participants will enter a 1-month run-in period, during which instruction on urine collection and dipstick readings will be carefully reviewed, compliance assessed, and therapy with ras inhibitors withdrawn and, in hypertensive children replaced by other anti-hypertensive drug. after run-in period, children will be randomized to either the intervention arm (ofatumumab) or the comparator arm (rituximab). after infusion of intervention or comparator, steroids will be maintained at initial dose for 30 days and then tapered off by 0.3 mg/kg per week until complete withdrawal. one week after the steroid withdrawal calcineurin inhibitors will be decreased by 50% and withdrawn within 2 additional weeks. all patients will be followed for up to 24 months. in case of relapses during the study (see outcome section for definition) patients will be treated with 60 mg/m2of prednisone p.o. in order to achieve remission. at remission, patients will be treated with another infusion of either oftumumab or rituximab, according to the initial randomization. after infusion of intervention or comparator, steroids will be maintained at initial dose for 30 days and then tapered off by 0.3 mg/kg per week until complete withdrawal. one week after the steroid withdrawal calcineurin-inhibitors will be decreased by 50% and withdrawn within 2 additional weeks. this strategy will be repeated to treat full relapses during the study.


Eligibility criteria:
inclusion criteria: to be eligible for inclusion into this study, participants will have to fulfill the following criteria: * to be in complete disease remission * drug dependence: remission has to be maintained with both steroids and cni steroid dependence is defined by two consecutive relapses during corticosteroid therapy or within 14 days of ceasing therapy. cni (cyclosporine/tacrolimus) dependence is defined by presence of relapse at discontinuation. * ability to provide consent and assent: parents'/guardian's written informed consent, and child's assent given before any study-related procedure not part of the subject's normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to his or her future medical care. * age between 2 and 24 years exclusion criteria: children will be excluded if any of the following criteria apply: * positivity to autoimmunity tests (ana, ndna, anca) * reduction of c3 levels. * egfr\<90/ml/min/1,73 m2 valuated according to revised bedside schwartz formula for patients between 2 and 17 years and with ckd-epi creatinine 2009 equation for 18 years old patients. * pregnancy * neoplasm * infections: previous or actual hbv (with hbeab positivity) or hcv infection * cd20 b lymphocytes count \<2,5% * treatment with rituximab or cyclophosphamide in the last 6 months
letrozole step-up protocol for ovulation induction in infertile women with pcos

Conditions: Infertility Poly Cystic Ovary

Summary: the aim of the study is to compare between the step-up and conventional protocols in ovulation induction in infertile women with pcos

the current study was conducted in private outpatient clinic after being approved by the medical ethics committee. the study is a prospective randomized study consisting of 90 egyptian patients diagnosed as having infertility with pcos . sample size determination: group sample sizes of 42 and 42 achieve 80% power based on study finding carried out by (galal et al., 2014) to detect a difference of 0.7 between the null hypothesis that both group means are 2.2 and the alternative hypothesis that the mean of group 2 is 1.5 with known group standard deviations of 1.5 and 0.6 and with a significance level (alpha) of 0.05000 using a two-sided mann-whitney test assuming that the actual distribution is uniform. sample size was calculated by pass 11 computer program for sample size calculation. taking into consideration 10% drop out rate, the sample size will be increased to 45 patients in group i and another 45 patients in group ii. patients were divided into two groups with randomization sheet: group (i): includes 45 females taking letrozole (old regimen). group (ii): includes 45 females taking letrozole 5 mg tab in a step-up protocol (new regimen).

Eligibility criteria:
inclusion criteria: * age: 20 -37 years old. * no conception for at least one year. * diagnosis of pco as established by rotterdam criteria, endometriosis diagnosed by laparoscope or unexplained infertility. exclusion criteria: * age \ 35 years old. * uterine pathology e.g. fibroid or ovarian cyst. * hyperprolactinemia, hypo or hyperthyroidism. * impaired hepatic or renal function. * history of hypersensitivity to study drugs.